Taming Laminitis - by Lenny Shulman

This commandment of horse racing well serves buyers examining the hooves of prospective purchases, but it has had a far more dire meaning for horses struggling with laminitis. The onset of this foot disease often signals the end of a Thoroughbred’s racing career, and too frequently becomes a life-threatening situation.

The pages of this issue touch on two special horses visited by the disease. We are uplifted to document the recovery of the Brazilian Triple Crown winner Bal a Bali, stricken just as he arrived in the United States for a run in the 2014 Breeders’ Cup World Championships that was not to be. However, thanks to the unwavering care of a team of veterinarians and a like commitment from his owners, Bal a Bali recovered from laminitis and won a graded stakes race here. Just last week, though, the racing world was hit with the devastating news that budding superstar Lady Eli had contracted the disease; her prognosis unknown.

For veterinarian researchers, laminitis, which took from us the great Secretariat, sits at or near the top of their “most want to solve” list. The disease involves inflammation of the soft tissue between a horse’s hoof wall and coffin bone. When that attachment fails, the bone’s suspension is lost, causing pain. It has been with us for a good while, referenced by Aristotle, who referred to it as “barley’s disease” because of the belief it was contracted through rich grain.

“It is such a critical and sensitive structure, and with the weight of the horse, any derangement leads to problems,” said Dr. James Belknap, professor of equine surgery at The Ohio State University and a leading laminitis researcher.

One of the most baffling aspects of laminitis is that it is brought on by a variety of insults. For Paynter, another happy success story, it was severe colitis. For Barbaro, whose journey ended in tragedy, it was a starting gate accident. Bal a Bali showed a bad bruise on a leg that worsened; grade II winner Intense Holiday was recovering from a condylar fracture when laminitis struck; Lady Eli stepped on a nail on the backstretch of Belmont Park. Horses become endangered when they compensate for one injury by putting too much weight on the opposite limb, which is a laminitic trigger.

While there is not yet a true cure for laminitis—and researchers don’t expect to find a silver bullet—research progress is being made and certain therapies are proving effective. Organizations such as the Grayson-Jockey Club Research Foundation and the American Association of Equine Practitioners Foundation Laminitis Research Project are committed to finding answers. Grayson has funded 20 grants for laminitis research in the past 15 years with better than $1.6 million. Starlight Racing, which lost Intense Holiday, offered matching funds up to $100,000 for research. With the drying up of federal funds, the work of foundations is critical, as is the support they receive from industry participants.

The doctors that worked on Bal a Bali attribute his recovery to a variety of promising therapies. Cryotherapy, stem cells, and sterile maggots played an important role in moving him past laminitis.

“We are making more rapid progress and testing things more quickly, including learning from human medicine,” said Dr. Belknap. “While testing effective therapies has moved us forward, we haven’t figured out the signaling because the laminae are affected by so many things.”

“We have made great strides in managing the condition once it occurs,” said renowned veterinary orthopedic surgeon Dr. Larry Bramlage, “and that has saved many horses. We still don’t have a good handle on preventing or neutralizing the disease at its initiation.”

The answer to the terrible puzzle that is laminitis will come from research and the knowledge that can be taken from the success of treatments on such survivors as Paynter and Bal a Bali. We pray that what we already know helps save Lady Eli, and that treatments yet to be formalized cure those that come after her.